AccountId: 011433970860
ContactId: 00029d21-68e2-4f08-9b4f-f479a8c288b0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202009 ms
Total Talk Time (AGENT): 97960 ms
Total Talk Time (CUSTOMER): 63461 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/00029d21-68e2-4f08-9b4f-f479a8c288b0_20250505T16:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Saint Louis Children's Hospital, calling to um verify insurance coverage for one of our patients.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I can take that eligibility for you. I'm sorry, you said your name was [PII], is that right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] I do. The policy number is 019078883.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] I have [PII].
[AGENT][NEUTRAL] Do you have that date of birth?
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that, uh, so this policy is active.
[CUSTOMER][NEUTRAL] Can you give me your name again, please?
[AGENT][NEUTRAL] Sure, it's uh [PII].
[CUSTOMER][NEUTRAL] [PII] got it and you said the policy is active?
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] Correct. Um, the effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] What's the effective date?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um,
[CUSTOMER][NEUTRAL] Is there um.
[CUSTOMER][NEUTRAL] Is this a HMO or PPO or do they need a pre cert?
[AGENT][NEUTRAL] No, absolutely not. As this policy is very dependent on uh major medical, as long as they're willing to pay, this policy can.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So there's no deductible or anything with this?
[AGENT][NEUTRAL] Uh, let me verify that some of them do have one.
[AGENT][NEUTRAL] OK. Of course, I will let you know verification of coverage is not a guarantee of payment for claims. They do have a deductible for outpatient, uh, for accident and sickness that is $1000.
[CUSTOMER][NEUTRAL] You said this is for outpatient?
[AGENT][NEUTRAL] There is no
[AGENT][NEUTRAL] That was uh the outpatient benefit and that was in regard to an accident or sickness. There is no deductible for inpatient.
[CUSTOMER][NEUTRAL] Alrighty, what if it is out of network?
[AGENT][NEGATIVE] Um, this policy doesn't work that way. Again, it's just very dependent on major medical, so as long as their major medical is willing to pay, this policy can. If major medical does not pay, this policy can't.
[CUSTOMER][NEUTRAL] Got it, OK.
[CUSTOMER][NEUTRAL] All righty. Is there a reference number for this call? Is there a reference number?
[AGENT][NEUTRAL] Alright, was there anything else I can help you with?
[AGENT][NEUTRAL] Sure, it would just be, it would just be my first name, last initial and today's date and so my last initial is A.
[CUSTOMER][NEUTRAL] In today's date.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty thank you so much.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APO. Have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you you too bye.
[AGENT][NEUTRAL] All right.